The interplay between infection risk factors of SARS-CoV-2 and mortality: a cross-sectional study from a cohort of long-term care nursing home residents
Por:
Soldevila, L, Prat, N, Mas, MA, Massot, M, Miralles, R, Bonet-Simo, JM, Isnard, M, Exposito-Izquierdo, M, Garcia-Sanchez, I, Rodoreda-Noguerola, S, Moreno, N, Badia, E, Lopez, G, Sevilla, J, Estrada, O and Valles, X
Publicada:
14 feb 2022
Resumen:
Background Covid-19 pandemic has particularly affected older people living in Long-term Care settings in terms of infection and mortality. Methods We carried out a cross-sectional analysis within a cohort of Long-term care nursing home residents between March first and June thirty, 2020, who were >= 65 years old and on whom at least one PCR test was performed. Socio-demographic, comorbidities, and clinical data were recorded. Facility size and community incidence of SARS-CoV-2 were also considered. The outcomes of interest were infection (PCR positive) and death. Results A total of 8021 residents were included from 168 facilities. Mean age was 86.4 years (SD = 7.4). Women represented 74.1%. SARS-CoV-2 infection was detected in 27.7% of participants, and the overall case fatality rate was 11.3% (24.9% among those with a positive PCR test). Epidemiological factors related to risk of infection were larger facility size (pooled aOR 1.73; P < .001), higher community incidence (pooled aOR 1.67, P = .04), leading to a higher risk than the clinical factor of low level of functional dependence (aOR 1.22, P = .03). Epidemiological risk factors associated with mortality were male gender (aOR 1.75; P < .001), age (pooled aOR 1.16; P < .001), and higher community incidence (pooled aOR 1.19, P = < 0.001) whereas clinical factors were low level of functional dependence (aOR 2.42, P < .001), Complex Chronic Condition (aOR 1.29, P < .001) and dementia (aOR 1.33, P <0.001). There was evidence of clustering for facility and health area when considering the risk of infection and mortality (P < .001). Conclusions Our results suggest a complex interplay between structural and individual factors regarding Covid-19 infection and its impact on mortality in nursing-home residents.
Filiaciones:
Soldevila, L:
Inst Catala Salut, Reg Sanitaria Metropolitana Nord, Int Hlth Program, Badalona, Spain
Hosp Badalona Germans Trias & Pujol, Infect Dis Unit, Badalona, Spain
Univ Autonoma Barcelona, Dept Med, Bellaterra, Spain
Fight AIDS & Infect Dis Fdn, Badalona, Spain
Prat, N:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
:
Inst Catala Salut, Direccio Clin Terr Cronicitat Metropolitana Nord, Badalona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Geriatr, Badalona, Spain
Massot, M:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Miralles, R:
Inst Catala Salut, Direccio Clin Terr Cronicitat Metropolitana Nord, Badalona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Geriatr, Badalona, Spain
Bonet-Simo, JM:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Isnard, M:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Exposito-Izquierdo, M:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Garcia-Sanchez, I:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Rodoreda-Noguerola, S:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Moreno, N:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Badia, E:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Lopez, G:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Sevilla, J:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
Estrada, O:
Inst Catala Salut, Direccio Atencio Primaria Metropolitana Nord, Sabadell, Spain
:
Inst Catala Salut, Reg Sanitaria Metropolitana Nord, Int Hlth Program, Badalona, Spain
Fight AIDS & Infect Dis Fdn, Badalona, Spain
Inst Recerca Ciencies Salut Germans Trias & Pujol, Badalona, Spain
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